P4847 - Endoscopic Sleeve Gastroplasty Impact on Metabolic Syndrome: An Umbrella Review of Systematic Reviews and Meta-Analyses

Muhammad Usman Baig, MBBS¹, Zane Gouda, MD², Sean Rangwani, MD², Kate E. Johnson, BA², Ali Lahooti, MD², Hakan Gelincik, MD³, Chino Aneke-Nash, MD², Mohannad Bisher Zuhair Al-Bakain, MBBS⁴, Sanad Tarick Haddad, MBBS⁵, Zuhair Osamah Zuhair Al-Bakaeen, MBBS⁴, Carolyn Newberry, MD⁶, Mark Hanscom, MD², Kartik Sampath, MD², SriHari Mahadev, MD², David Carr-Locke, MD, FACG², Reem Z.. Sharaiha, MD, MSc¹
1Weill Cornell Medical College, New York, NY; 2Weill Cornell Medicine, New York, NY; 3NYC Health + Hospitals/Woodhull, Brooklyn, NY; 4Jordan University of Science and Technology, Irbid, Irbid, Jordan; 5University of Jordan, Amman, 'Amman, Jordan; 6NewYork-Presbyterian / Weill Cornell Medical Center, New York, NY

Introduction: Endoscopic sleeve gastroplasty (ESG) results in total body weight loss of approximately 15–20%, yet its impact on obesity-related metabolic comorbidities remains less well characterized. We conducted an umbrella review of systematic reviews and meta-analyses to evaluate the efficacy of ESG in managing metabolic syndrome.

Methods: A comprehensive search of PubMed, MEDLINE, Web of Science, Scopus, and Embase was conducted to identify systematic reviews and meta-analyses reporting metabolic outcomes following ESG. Studies were included if they assessed either disease remission or objective laboratory measures. Disease remission was defined as the discontinuation of all antidiabetic medications. Outcomes were reported as risk differences (RD) and mean differences (MD), each with 95% confidence intervals (CI), using a random-effects model.

Results: Six meta-analyses met the inclusion criteria. ESG was associated with significant disease remission compared to pre-procedure baseline: type 2 diabetes mellitus (T2DM) (RD = –61% [95% CI: –78, –44]; P < 0.00001), dyslipidemia (RD = –59% [95% CI: –67, –51]; P < 0.00001), and hypertension (RD = –61% \[95% CI: –71, –52]; P < 0.00001) (Figures 1a–1c). Laboratory outcomes also showed significant improvements: HbA1c (MD = –0.60% [95% CI: –0.84, –0.36]; P < 0.00001), triglycerides (MD = –36.67 mg/dL \[95% CI: –52.53, –20.80]; P < 0.00001), and alanine aminotransferase (ALT) (MD = –14.07 U/L \[95% CI: –23.99, –4.16]; P = 0.005) (Figures 2a–2c).

Discussion: This umbrella review demonstrates that ESG leads to meaningful remission of T2DM, dyslipidemia, and hypertension, along with significant improvements in key metabolic lab markers. These findings highlight ESG’s potential role as a metabolic intervention beyond weight reduction alone.


Figure: Figure 1a. Forest plot for T2DM remission
Figure 1b. Forest plot for dyslipidemia (DLD) remission
Figure 1c. Forest plot for hypertension remission


Figure: Figure 2a. Forest plot for HbA1c change
Figure 2b. Forest plot for triglyceride change
Figure 2c. Forest plot for ALT change

Disclosures:
Muhammad Usman Baig indicated no relevant financial relationships.
Zane Gouda indicated no relevant financial relationships.
Sean Rangwani indicated no relevant financial relationships.
Kate Johnson indicated no relevant financial relationships.
Ali Lahooti indicated no relevant financial relationships.
Hakan Gelincik indicated no relevant financial relationships.
Chino Aneke-Nash indicated no relevant financial relationships.
Mohannad Bisher Zuhair Al-Bakain indicated no relevant financial relationships.
Sanad Tarick Haddad indicated no relevant financial relationships.
Zuhair Osamah Zuhair Al-Bakaeen indicated no relevant financial relationships.
Carolyn Newberry: Eli Lilly & Co – Consultant.
Mark Hanscom indicated no relevant financial relationships.
Kartik Sampath: CONMED – Consultant.
SriHari Mahadev: Boston scientific – Consultant. Conmed – Consultant.
David Carr-Locke: Boston Scientific – Consultant. Steris Corporation – Royalties.
Reem Sharaiha: Boston Scientific – Consultant. Cook Medical – Consultant. Olympus – Consultant. Surgical Intuitive – Consultant.

Muhammad Usman Baig, MBBS¹, Zane Gouda, MD², Sean Rangwani, MD², Kate E. Johnson, BA², Ali Lahooti, MD², Hakan Gelincik, MD³, Chino Aneke-Nash, MD², Mohannad Bisher Zuhair Al-Bakain, MBBS⁴, Sanad Tarick Haddad, MBBS⁵, Zuhair Osamah Zuhair Al-Bakaeen, MBBS⁴, Carolyn Newberry, MD⁶, Mark Hanscom, MD², Kartik Sampath, MD², SriHari Mahadev, MD², David Carr-Locke, MD, FACG², Reem Z.. Sharaiha, MD, MSc¹. P4847 - Endoscopic Sleeve Gastroplasty Impact on Metabolic Syndrome: An Umbrella Review of Systematic Reviews and Meta-Analyses, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.